Children with psoriasis may be at increased risk for overweight and obesity

November 19, 2012

CHICAGO - A study of children in nine countries found that psoriasis in children was associated with an increased risk for overweight and obesity, regardless of psoriasis severity, according to a report published Online First by Archives of Dermatology, a JAMA Network publication.

"Adults with psoriasis have an increased risk of obesity, myocardial infarction, stroke and diabetes mellitus," the authors write as background in the study. "Recent studies also suggest the association of psoriasis with obesity in children."

Amy S. Paller, M.D., with Northwestern University, Chicago, and colleagues examined the association between excess adiposity (body mass index [BMI] percentile) and central adiposity (waist circumference percentile and waist to height ratio) with pediatric psoriasis severity. The authors conducted a multicenter, cross-sectional study of 409 children with psoriasis and 205 control children from nine countries between June 19, 2009 and December 2, 2011.

Psoriasis was classified as mild (worst Physician's Global Assessment score ≤3 with body surface area ≤10 percent) or severe (worst Physician's Global Assessment score ≥3 with body surface area >10 percent).

Excess adiposity (BMI ≥85th percentile) occurred in 37.9 percent of children with psoriasis (n=155) vs. 20.5 percent of children in the control group (n=42), but did not differ by psoriasis severity. Waist circumference above the 90th percentile occurred in 9.3 percent of children in the control group (n=19), 14 percent in the mild psoriasis group (n=27) and 21.2 percent in the severe psoriasis group (n=43), internationally.

Additionally, waist to height ratio was significantly higher in children with psoriasis (0.48) vs. those in the control group (0.46) but was unaffected by psoriasis severity. Children with severe psoriasis at its worst, but mild psoriasis at enrollment, showed no significant difference in excess or central adiposity than children whose psoriasis remained severe.

"In conclusion, children with psoriasis internationally, regardless of severity, are more likely to be overweight or obese and thus are at increased risk for complications related to excess adiposity," the authors write. "Should further studies show excess adiposity to be a precursor for psoriasis, attempts at early weight loss and lifestyle modification will be important, not only to decrease the risk of metabolic disease but also to modulate the course of pediatric psoriasis."

(Arch Dermatol. Published online November 19, 2012. doi:10.1001/jamadermatol.2013.1078.)

Editor's Note: This study was supported by a grant from the International Psoriasis Council, which participated in study design and served as the repository of de-identified information. The International Psoriasis Council had no role in the analysis and interpretation of the data or in the preparation, review, or approval of the manuscript. Several authors also submitted conflict of interest disclosures, which are listed in the article. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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To contact Amy S. Paller, M.D., call Marla Paul at 312-503-8928 or email marla-paul@northwestern.edu.

The JAMA Network Journals

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